Fingerprint and Biographical Affidavit Requirements

1 2018 National Association of Insurance Commissioners 1 06/29/2018 Fingerprint and Biographical Affidavit Requirements A link to the Application instructions for Primary Application, Section II, Filing Requirement Item 13; Expansion Application, Section II, Filing Requirement Item 12; and Corporate Amendment Application Section V, Filing Requirement Item 9 and Section VI, Filing Requirement Item 6. Updates to the State-Specific Information State Domiciliary Requirements Licensure (Primary) and After Licensure Non-Domestic Requirements For Licensure (Expansion or Corporate Amendment Application) Non-Domestic Requirements After Licensure (Updates only) AL Contact State Directly for Requirements NAIC Biographical Affidavit and Independent Thir d-Party Verification. If requested a NAIC Biographical Affidavit is required for new officers/directors of foreign insurers, within 15 days of request.

2 AK Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification After Licensure: NAIC Biographical Affidavits are not required. NAIC Biographical Affidavit and Independent Thir d-Party Verification NOTE: Verification reports should be sent to the state at the time of submission of the application. Reports received without an application pending will be destroyed. NAIC Biographical Affidavit is not required for new officers or directors. AZ Licensure: NAIC Biographical Affidavit AND Independent Third-P arty Ve rif ication After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel. NAIC Biographical Affidavit AND Independent Third-Party Verification. NAIC Biographical Affidavit is not required for new officers or directors. AR Licensure: NAIC Biographical affi davit and Independent Third-Party Verification.

3 After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel. NAIC Biographical Affidavit and Independent Thir d-P art y Verifications. NAIC Biographical affidavits are not required for new officers or a director, assuming the domestic state is reviewing changes. CA Primary: Fingerpri nts and NAIC Biographical affidavits. Please contact California's Department of Insurance directly at (415) 538-4035 to request the necessary Fingerprint live scan After Licensure: NAIC Biographical affidavits are required for changes in Officers, Directors or Key Managerial Personnel. NAIC Biographical Affidavit and Fingerprint live scans, please contact California's Department of Insurance directl y at (415) 538-4035 to request the necessary Fingerprint live scan, forms and i nformation.

4 NAIC Biographical Affidavit and Finger print live scan is required for new officers,/directors within a reasonable time. 2018 National Association of Insurance Commissioners 2 06/29/2018 State Domiciliary Requirements Licensure (Primary) and After Licensure Non-Domestic Requirements For Licensure (Expansion or Corporate Amendment Application) Non-Domestic Requirements After Licensure (Updates only) CO Contact State Directly for Requirements NAIC Biographical Affidavits and Independent Thir d-Party Verification reports for all foreign companies. NAIC Biographical Affidavit is not required for new officers or directors. CT Licensure: NAIC Biographical Affidavits and Independent Third-part y Verification. After Licensure: NAIC Biographical Affidavits are required when there is a change in Officers, Directors or Key Managerial Personnel.

5 Expansion: NAIC Biographical Affidavits and Independent Third-part y Verification. License/Corporate Amendment: NAIC biographi cal affidavits are required for new officers/directors if not previously provided. A NAIC Biographical Affidavit is required for new officers/directors as soon as possible. DE Licensure: NAIC Biographical Affi davit. After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel. NAIC Biographical Affidavit . A NAIC Biographical Affidavit is required for new officers or directors listed on the NAIC Jurat page of the annual statement within a reasonable time frame. DC Contact State Directly for Requirements NAIC Biographical Affidavit and Independent Third-Party Verification NAIC Biographical Affidavit is not required for new officers or directors.

6 FL Licensure: NAIC Biographical Affidavit , Independent Third-Party Verification and Fingerprint Cards ( Fingerprint LiveScan available for Florida Residents Onl y). Refer to State Specific Requirements for Fingerprint Procedures. Please contact the Office of Insurance Regulation at (850) 413-2575 to request the necessary Fingerprint cards or Effective August 16, 2007, Florida no longer requires credit reports with the background investigations. NAIC Biographical Affidavit , Independent Third-Party Verification and Fingerprint Cards ( Fingerprint LiveScan available for Florida Residents Onl y). Refer to State Specific Requirements for Fingerprint Procedures. Please contact the Office of Insurance Regulation at (850) 413-2575 to request the necessary Fingerprint cards or Effective August 16, 2007, Florida no longer requires credit reports with the background investigations.

7 A NAIC Biographical Affidavit is required for new key officers. GA Contact State Directly for Requirements NAIC Biographical Affidavit and Independent Third-Party Verification Contact state for Requirements . HI Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification After Licensure: A NAIC Biographical Affidavit and Independent third-party verification report is required for changes in Officers, Directors or Key Managerial Personnel. NAIC Biographical Affidavit and Independent Third-Party Verification Sally D. Bautista Phone #: (808) 586-7414 NAIC Biographical Affidavit is required for new officers when filing for Mergers and Acquisitions only. ID Contact State Directly for Requirements NAIC Biographical Affidavit and Independent Third-Party Verification A NAIC Biographical Affidavit and Independent Third-Party Verification report is not required for new officers or directors provided the company files annual and quarterly financial statements electronically with the NAIC.

8 Foreign insurers licensed in Idaho are not required to file separate notices of changes in officers and directors. 2018 National Association of Insurance Commissioners 3 06/29/2018 State Domiciliary Requirements Licensure (Primary) and After Licensure Non-Domestic Requirements For Licensure (Expansion or Corporate Amendment Application) Non-Domestic Requirements After Licensure (Updates only) IL Licensure: NAIC Biographical Affidavits with original signatures required for all domestic companies Officers and Directors. Independent Third Party Verification Reports are required for all Officers and Directors. After Licensure: NAIC Biographical Affidavits with original signatures are required for changes in Officers or Directors; Independent Third Party Verification are required for new Officers or Directors. Notification of a change in officers or directors is required within 30 days.

9 A copy of the NAIC Biographical Affidavits for all foreign companies. Independent Third-Part y Verification are required for each Officer and Director of the applicant. NAIC Biographical Affidavit is required for new officers or directors. Notification of a change in officers or directors is required within 30 days. Independent Third-Party Verifications are required for new officers and directors. IN Licensure: Indiana Biographical Affidavits with original signature and Independent Third- Party Verification required for all domestic companies After Licensure: Originall y signed Indiana Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel. Indiana Biographical Affidavits with original signature and Independent Third-Party Verification. Notification of a change in officers or directors is required within 30 days.

10 An Indiana Biographical Affidavits and Independent Third-Party Verification upon request for new officers or directors. IA Contact State Directly for Requirements NAIC Biographical Affi davit and Independent Third-Party Verification. NAIC Biographical Affidavit is not required for new officers or directors. KS Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification. After Licensure: NAIC Biographi cal Affidavit for changes in officers and directors as listed on page one of the annual statement within 30 days after the changes or actions become effective or are otherwise finalized. Expansion --- NAIC Biographical Affidavit and Independent Third- Party Verification. NAIC Biographical Affidavit is not required for new officers and directors. Notification required via the Kansas DESK TOP system of any change in President or Corporate Secretary KY Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification After Licensure: Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.